Individual
DR. ROBERT LYLE MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11820 SW KING JAMES PL STE 20, TIGARD, OR 97224-2481
(503) 968-2901
(503) 406-4988
Mailing address
27440 SW VANDERSCHUERE RD, HILLSBORO, OR 97123-9439
(503) 964-8909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11114
OR
Other
Enumeration date
03/20/2018
Last updated
09/10/2019
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